Transcultural validity of a structured diagnostic interview to screen for major depression and posttraumatic stress disorder among refugees
ABSTRACT Refugees and asylum seekers have a high risk of developing mental health problems and appropriate screening in people from diverse origins remains a challenge. The aim of this study was to validate a structured diagnostic interview, adapted from the Major Depressive Episode (MDE) and Posttraumatic Stress Disorder (PTSD) sections of the Mini International Neuropsychiatric Interview, to detect these disorders among newly arrived asylum seekers. The adapted questionnaire was administered by nurses in a primary care context and its performance was judged against the expert opinion of a mental health specialist. One hundred one subjects were included in the study (mean age: 30; origin: Africa 58%, Europe: 37%, Asia: 5%). MDE and PTSD were diagnosed among 33% and 30% of them respectively. The questionnaire demonstrated moderate sensitivity (MDE: 79%; PTSD: 69%), but high specificity (MDE: 95%; PTSD: 94%). These characteristics remained stable despite cultural differences and use of interpreters. This instrument could be used for systematic screening of MDE and PTSD in refugees from various origins.
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ABSTRACT: The association between cognitive performance and general functioning in depression is controversial. The present study evaluated the association between cognitive dysfunction and major depressive disorder (MDD, N=70) as compared with age- and gender-matched healthy controls (n=206) and its relationship to general functioning (physical and mental health quality of life, activities of daily living, and employment status) in participants with current MDD (n=26) and those with previous MDD only (n=44). Participants were assessed clinically using the Mini International Neuropsychiatric Interview (M.I.N.I.) for the depression groups and the Diagnostic Interview for Psychoses (DIP-DM) for the control group. Measures to evaluate cognition and quality of lifes comprised the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS), the Short Form-36 Health Survey Questionnaire, and the Activities/Instrumental Activities of Daily Living (ADL/IADL); employment status was also assessed in MDD. The results showed that a) while individuals with current depression had worse cognitive performance in all domains than healthy controls, those individuals with previous depression had lasting cognitive impairments in the domains of immediate memory and attention as compared with healthy controls; b) individuals with current depression had lower scores in the visuospatial/constructional and attention domains and the total score than individuals with previous depression; c) individuals in the depression group as a whole who were currently unemployed had significantly lower scores in all domains (except attention) of cognitive function; d) cognitive function was not related to either physical or mental quality of life or impairments of activities of daily living (ADL, IADL); e) that unemployment in previous depression was related to poor cognitive function similar to those with current depression. The results indicate that MDD may have detrimental and lasting effects on cognitive performance partly related to poorer general functioning.Psychiatry Research 02/2010; 176(2-3):183-9. DOI:10.1016/j.psychres.2008.12.001 · 2.68 Impact Factor
- PPmP - Psychotherapie · Psychosomatik · Medizinische Psychologie 01/2008; 58:109-122. DOI:10.1055/s-2008-1067358 · 1.02 Impact Factor
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ABSTRACT: The subspecialty of international emergency medicine (IEM) continues to grow within the United States, just as the specialty of emergency medicine (EM) continues to spread to both developed and developing countries around the world. One of the greatest obstacles, however, faced by IEM researchers and practitioners alike, remains the lack of a high-quality, consolidated, and easily accessible evidence-base of literature. In response to this perceived need, members of the Emergency Medicine Resident Association (EMRA) International Emergency Medicine Committee, in conjunction with members of the Society for Academic Emergency Medicine (SAEM) International Health Interest Group, have embarked on the task of creating a recurring review of IEM literature. This publication represents the third annual review, covering the top 30 IEM research articles published in 2007. Articles were selected for the review according to explicit, predetermined criteria that included both methodologic quality and perceived impact of the research. It is hoped that this annual review will act as a forum for disseminating best practices, while also stimulating further research in the field of IEM.Academic Emergency Medicine 08/2008; 15(9):860 - 865. DOI:10.1111/j.1553-2712.2008.00222.x · 2.20 Impact Factor